2006/08/30 09:30 Alok Chakrabarti, "Technology and Innovation in the Services: Some Issues and Research Needs"

2006/08/30 09:30 Alok Chakrabarti, "Technology and Innovation in the Services: Some Issues and Research Needs"

Submitted by daviding
on Mon, 01/30/2017 - 21:53

Services Engineering and Management Summer School, Helsinki University of Technology, August 28-September 2

This digest was created in real-time during the meeting, based on the speaker's presentation(s) and comments from the audience. The content should not be viewed as an official transcript of the meeting, but only as an interpretation by a single individual. Lapses, grammatical errors, and typing mistakes may not have been corrected. Questions about content should be directed to the originator. The digest has been made available for purposes of scholarship, posted on the Coevolving Innovations web site by David Ing.

Alok Chakrabarti, New Jersey Institute of Technology

Long discussion with Saara on content

Saara: Today's focus will be on information-intensive and knowledge-intensive approach

Marja will describe the more humanistic perspective later

As focus, will look into health care

Health care means a lot of things for a lot of programs

Four objectives in healthcare:

Preventive, e.g. smallpox eradication, have a lot of programs in vaccinations

Supposed to take flu shot, but then have to pay if under 65

Curative: anti-infective drugs, curing a certain disease

Disease management: e.g. hypertension, not curing but managing the disease for life extension

Quality of life improvement: not curing or extending life, but improving quality for someone who has a disease

Where you provide the service, ontological:

Doctor-patient in situ, i.e. the same place

Doctor's office

Ambulatory care, go there a few hours, then go home

Hospital, for a few days

Nursing home (in the U.S. means long term care, as opposed to in India where it means private hospital)

Provides long-term insurance

Very expensive, about $150K-$200K per year

Can't get this reimbursed by the government, until you exhaust your assets

There are laws about asset dispositions

If you're ill, and about to enter a nursing home, you can't transfer your home to your children, need to look 3 years back

Hospice: quality of life management issue, for terminal patients

Can we have doctor-patient in different locations

Telemedicine: Karita was speaking about Palo Alto, messaging systems

Vodaphone, put phone on chest, and it will send information to heart specialists

Time: temporal dimensions in health care delivery

Chronic <--> acute

Emergency <--> non-emergency

John Hopkins in Baltimore, lots of experience with gun shots

Ecosystem of health care delivery

Patient

Doctor

Lots of other actors in health care delivery:

Regulators

Financing system

Medical device manufacturers

Pharmaceuticals

Diagnostic services

Hospital

Nurses and paramedics provide quality of health care

J&J executive: soon you won't need a medical device, because will inject stem cells and the injured parts will grow back

In the future, doctors could look at genes, and will give you something will act specifically on the gene part

Alfred Park, NY, good technology on glass, doing research on implanting glass beads into tumour, then changes in the magnetic field will cause 1 to 2 degree F change, enough to kill cancer cells

Why do drug trials take so long?

Thalmidomide: wouldn't know unless had a test for a long time

DES: given to mothers for morning sickness, babies healthy, but then female children at a later stage (30 years later) developed uterine cancer

In India, drug manufacturers may not provide medicine with full strength

Who controls the efficacy of the drugs?

A lot of people go to hospitals, and catch a new disease

Pharmaceutical value chain

Pre-clinical development

Could be NCE New Chemical Entity, new molecule; or NDA New Drug Application, used in a different way

Clinical development

Manufacturing Operations

Sales and Marketing

Traditionally, pharmaceutical has been based in organic chemistry

e.g. Turku is good in chemistry

(1) Stem cells are biotechnology, not chemistry

(2) Use of computer technology to develop designer drugs, specific drugs to act on cells

Computational biology, combinatorial chemistry

By breaking out the value chain, small companies spread the risk

In clinical trials, double-blind tests, are done by large companies

Manufacturing is now outsourced, to China or India

Marketing is done by large pharmas, have a brand name

New systems are developing, issue is orchestration

Big pharma is becoming an orchestrator

Deep ethical issues, e.g. trials in third world countries as being guinea pig; or patients receiving placebos

In 1930s, tests on syphilis in Alabama prison system, blacks

At universities today, have to get approval of human study committees

Issues related to preventive programs:

Generally audience is large, e.g. smallpox or malaria

Have to teach, and have behavioural modification

e.g. TB, take a few pills and the fever breaks, so they don't finish the whole prescription

This DOTS: Directly Observed Treatment System, take the medicine in front of the nurse

Issues for curative systems:

Access

Diagnostic services

Pharmaceuticals

Infrastructure

Financing system

Issues related to long term care:

Facilities

Access

Financing

Pharma

Technology bases

Core: Medical science and technology

Enabling: ICT

Supplementary: Logistics, transportation

Hype cycle for health care, from Gartner

RFID to tag emergency room equipment, so that know where it is

PDA direct prescription through wireless to pharmacy

[Questions]

What do you do research in?

It depends on who's funding.

Interested in technology and business gap.

Home care?

Lillrank: People would prefer to die at home.

Monitoring technology, e.g. floor sensors to know person is moving in the room

Karita: looked at dermatologist, video conferencing, could see 40% more patients; EHR will probably help accelerate home care; challenge that don't know what happens when the line goes down except for doctor sitting and watching monitor

Professions?

New roles: nurse practitioner, physician's assistant

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